Provider Demographics
NPI:1891351318
Name:HARDWICK, STACI MARIE (LPCC)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:MARIE
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 ASHGROVE RD
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-9202
Mailing Address - Country:US
Mailing Address - Phone:859-907-8748
Mailing Address - Fax:
Practice Address - Street 1:1115 ASHGROVE RD
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-9202
Practice Address - Country:US
Practice Address - Phone:859-907-8748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health